California Psychiatric Association Documents
	Overview of Modern Psychiatry: The Art and Science of Diagnosing and Treating Mental Disorders

September, 2002

Today's Psychiatric Physician

Today's psychiatrist is a physician who specializes in diagnosing and treating the brain malfunctions commonly called mental illness, just as a cardiologist treats heart disease or an internist treats diabetes. Only the psychiatrist is fully trained to determine whether what appear to be "psychological problems" are a mental illness or the manifestation of another illness. After graduating from medical school, they complete 4 or more years of residency in general medicine and the specialty of disorders of the brain and mind called psychiatry.

Exciting scientific discoveries of the last decade and the specialized training of modern psychiatry have combined to change the face of mental health care. Psychiatrists are the only health care professionals who are fully qualified to identify the source of a "mental" problem and to develop appropriate treatment decisions. A modern psychiatrist reviews medical records, examines patients, analyzes laboratory reports, and develops a treatment plan which may include a prescription for medication, further medical tests, psychotherapy, lifestyle or behavioral changes, or a combination of these.

Various forms of psychotherapy still play a fundamental role in the treatment of many patients. In addition to psychotherapy provided by psychiatrists, limited-license, non-medical mental health professionals provide therapy for people who are having mental, emotional, interpersonal, or family problems. These include social workers and marriage and family therapists, who have 2 or more years of post-graduate training, and psychologists, who have non-medical doctoral degrees.

New Understanding of the Brain

Thanks to new discoveries in genetics, modern brain research and advances in psychiatry, mental illness is no longer the frightening mystery it once was. Today we know that the most serious mental illnesses, such as schizophrenia, depression, bipolar disorder, obsessive-compulsive disorder, panic disorder, and ADHD have genetic and biological bases similar to diabetes, heart disease, or high blood pressure. Researchers have found genes linked to some of these disorders and are actively seeking those linked to others. Using computerized brain imaging techniques, physicians are able to show chemical abnormalities in the brains of those suffering from schizophrenia and other mental disorders.

We now know that many illnesses manifested by psychological symptoms are actually the result of physical disorders. Depression, nervousness, or sadness can be caused by strokes, thyroid disease, other endocrine disorders, auto-immune disease or tumors. While memory loss and confusion can also be caused by many different medical conditions, we know that some mental symptoms can be caused by medication side effects or drug interactions. Because of such breakthrough, many of yesterday's psychological mysteries are today being treated medically with success. At the same time, because of these many advances, the medical treatment of brain disorders has become more complex, challenging the full medical training of psychiatrists.

See also The Art and Science of Diagnosing and Treating Mental Disorders